Title : Cognitive function and its association with frailty after the cessation of senior citizen classes for the elderly in the community in Japan
Abstract:
Community older people had to discontinue social activities due to the COVID-19 epidemic. The study investigated changes in cognitive function and frailty due to the cessation of activities in the senior citizen classroom.
Cognitive function did not decline over the three-year period. Cognitive memory and executive function were associated with low nutrition and physical activity. The study showed the need to maintain exercise function and prevent low nutrition in order to maintain cognitive function and prevent frailty.
Objectives: To determine the impact of social activity limitations related to the COVID-19 epidemic on the association between cognitive function and frailty in the elderly community.
Methods: Participants 65 years and older enrolled in the Senior Citizen Classroom Program (49 participants in 2019 and 19 participants in 2022).
Prospective cohort study; questionnaires were demographics, kihon checklist (KCL) and cognitive function tests (group-based Matsui word memory test, Yamaguchi Kanji code conversion test and word recall test). The KCL screens older people who will need long-term care in the near future. It consists of 25 questions in seven domains: activities of daily living, fall anxiety, low nutrition, oral function, cognitive function and depressed mood. The Matsui Word Memory Test consists of <immediate replay> and <delayed replay>. The immediate replay test assesses the ability to recall the required words in a short time. Delayed playback assesses the ability to recall, after a period of time. The Yamaguchi Kanji Conversion Test assesses frontal lobe function (executive function and attention). The Word Recall Test assesses the ability to recall as many animal words as possible in one minute.
Cognitive function was scored based on the total number of responses obtained.
Descriptive statistics were analyzed using SPSS, correlation analysis and t-tests. The significance level was set at p<.05.
Ethical considerations: the study was approved by the ethical review committee of the affiliated university.
Results: Participant demographics were baseline (20 men and 29 women, mean age 69.9 years, SD 3.7) and follow-up (12 men and 7 women, mean age 73.6 years, SD 3.6).
There was no significant decline in cognitive function scores between 2019 and 2022. Cognitive function was maintained.
The association between KCL and cognitive function in 2019 was that low nutritional status was positively associated (r=.323) with kanji conversion (executive dysfunction). There were weak correlations with immediate playback (r=.254) and word recall (r=.226). The cognitively impaired group was significantly (p<.05) associated with stair walking and fall anxiety.
Conclusions: Cognitive function in the elderly was relatively well maintained after discontinuation of social activities with COVID-19. Cognitive function was correlated with low nutritional status. Decline in cognitive function was associated with frailty risk, including exercise and nutrition. Maintaining exercise and preventing low nutrition are necessary to maintain cognitive function and prevent frailty.
